31D2194809 CLIA NUMBER - MEDICINE MAN PHARMACY & COMPOUNDING

Laboratory Demographics

  • CLIA Code: 31D2194809
  • Facility Name: MEDICINE MAN PHARMACY & COMPOUNDING
  • Facility Address: 511 WASHINGTON ST
    HOBOKEN, NJ
    ZIP 07030
  • Facility Phone: 201 942-9777
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BINO CHANDY
  • NPI Number: 1598009383
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 31D2194809
LAB Type Pharmacy
Facility Name MEDICINE MAN PHARMACY & COMPOUNDING
Street 511 WASHINGTON ST
City HOBOKEN
State NJ
ZIP 07030
Phone 201 942-9777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Pharmacy
Lab Director BINO CHANDY

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This page was last updated on: 9/29/2025